Apparatus for the introduction and manipulation of multiple telescoping catheters

A method, comprising:

• inserting a steerable shaft of a delivery apparatus into the body of a patient;
• wherein a pull-wire extends through a pull-wire conduit that extends at least partially through the steerable shaft,
• wherein the steerable shaft has one or more layers;
• wherein the steerable shaft includes a compression-resistance portion incorporated into at least one of the one or more layers of the steerable portion;
• wherein a cross-section of the compression-resistance portion has an arcuate shape that extends along a portion of a cross-section of the steerable shaft;
• wherein the compression-resistance portion has a hardness that is greater than a hardness of the one or more layers that the compression-resistance portion is incorporated into;
• applying tension to the pull wire to adjust the curvature of the distal portion of the shaft.

A system, comprising:

• a steerable guide sheath comprising:
• a steerable shaft having a pull-wire conduit;
• a pull wire extending through the pull-wire conduit;
• wherein the steerable shaft has one or more layers;
• wherein the steerable shaft includes a compression-resistance portion incorporated into at least one of the one or more layers of the steerable portion;
• wherein a cross-section of the compression-resistance portion has an arcuate shape that extends along a portion of a cross-section of the steerable shaft;
• and
• wherein the compression-resistance portion has a hardness that is greater than a hardness of the one or more layers that the compression-resistance portion is incorporated into;
• an adjustment mechanism connected to a proximal end portion of the guide sheath and configured to increase and decrease tension in the pull wire to adjust the curvature of a distal portion of the steerable guide sheath;
• an implant catheter coaxially disposed within the guide sheath;
• and
• a prosthetic device mounted on a distal end of the implant catheter.